From spine to heart: a case report of massive cement embolism following vertebroplasty

Abstract Background Percutaneous vertebroplasty is a commonly used, minimally invasive therapeutic intervention to relieve pain caused by vertebral compression fractures, which are becoming more prevalent due to the aging population. Although the procedure is generally safe, complications such as cement leakage into the bloodstream can occur. Case summary We present the case of a 67-year-old female with a history of advanced osteoporosis and multiple vertebroplasty procedures who developed dyspnoea 5 months after her most recent surgery. Imaging revealed an intracardiac cement embolism extending from the inferior vena cava through the right atrium and tricuspid valve into the right ventricle. This rare complication of vertebroplasty, caused by cement leakage, resulted in tricuspid valve regurgitation and pulmonary hypertension. Discussion This case highlights the importance of recognizing and managing the rare complications of vertebroplasty by using a multimodality imaging approach, especially in patients with a history of multiple procedures.